KELLY ASHLEY BOARDMAN (NPI# 1821492067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821492067 |
| Entity Type | Individual |
| Full Name | KELLY ASHLEY BOARDMAN |
| Credential | PA-C |
| Practice Address |
19415 Deerfield Ave Suite 213 Leesburg VA 20176-8452 |
| Mailing Address |
2623 Puritan Ct Herndon VA 20171-2439 |
| Practice Telephone | 7037299220 |
| Practice Fax Number | 7038583529 |
| Mailing Telephone | 4043262826 |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110004747 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437522430 | Kelly Boardman | Marriage & Family Therapist | 510 S 2nd Ave Ste 7, Covina, CA 91723-3017 | 2015-11-12 |
| Street Address |
19415 DEERFIELD AVE SUITE 213 |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-8452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558745794 | Loudoun Medical Group PC | Surgery | 19415 Deerfield Ave, Suite 213, Leesburg, VA 20176-8452 | 2015-07-17 |
| 1649662339 | Crescent Medical Arts | Internal Medicine | 19415 Deerfield Ave, Suite 213, Leesburg, VA 20176-8452 | 2015-03-04 |
| 1356780746 | Rachel Swinger Sposito | Nurse Practitioner | 19415 Deerfield Ave, Suite 202, Leesburg, VA 20176-8452 | 2013-06-18 |
| 1093066284 | Mari E Parker | Nurse Practitioner | 19415 Deerfield Ave, Suite 112, Leesburg, VA 20176-8452 | 2012-09-27 |
| 1174879944 | Loudoun Medical Group PC | Internal Medicine | 19415 Deerfield Ave, Suite 107, Leesburg, VA 20176-8452 | 2012-07-31 |
| 1366709651 | Loudoun Medical Group PC | Pediatrics | 19415 Deerfield Ave, Suite 213, Leesburg, VA 20176-8452 | 2012-04-12 |
| 1093091530 | Navin Hukmani, Dds, LLC | Dentist | 19415 Deerfield Ave, Suite 306, Leesburg, VA 20176-8452 | 2011-10-28 |
| 1922325000 | Kathleen I Cage | Nurse Practitioner | 19415 Deerfield Ave, Suite 112, Leesburg, VA 20176-8452 | 2010-04-28 |
| 1588827968 | Christopher L. Starks | Urology | 19415 Deerfield Ave, Suite112, Leesburg, VA 20176-8452 | 2008-07-07 |
| 1740479971 | Jennifer Lee Young | Urology | 19415 Deerfield Ave, Suite 112, Leesburg, VA 20176-8452 | 2007-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
| 1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
| 1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
| 1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
| 1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
| 1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
| 1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
| 1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| Find all providers in zip 20176 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811439169 | Anthony Mark Rodrigues | Physician Assistant | 224 Cornwall St Nw Ste D, Leesburg, VA 20176-2701 | 2016-11-16 |
| 1770828774 | John O'hara Snow | Physician Assistant | 18706 Woodburn Rd, Leesburg, VA 20175-9030 | 2012-12-01 |
| 1285622829 | John A Horn | Physician Assistant | 600 Dixie Hwy, Leesburg, FL 34748 | 2005-10-07 |
| 1285195487 | Elizabeth Baek | Physician Assistant | 19450 Deerfield Ave Ste 325, Leesburg, VA 20176-8503 | 2019-03-29 |
| 1437629490 | Alexandrea Weeks | Physician Assistant | 1801 Us Highway 441 Bldg 100, Leesburg, FL 34748-2545 | 2018-12-03 |
| 1710461595 | Grace Fantl | Physician Assistant | 27950 Us Highway 27, Leesburg, FL 34748-9050 | 2018-09-18 |
| 1588061956 | Jaster Francis | Physician Assistant | 44035 Riverside Pkwy, Leesburg, VA 20176 | 2014-12-01 |
| 1073919197 | Alexandra Jean Bache | Physician Assistant | 44035 Riverside Pkwy Ste 400, Leesburg, VA 20176-8260 | 2014-11-17 |
| 1437564911 | Ellen T. Godfrey | Physician Assistant | 601 Potomac Station Dr Ne, Leesburg, VA 20176-1816 | 2014-06-24 |
| 1497993802 | Ilyas Gutale | Physician Assistant | 600 E Dixie Ave, Leesburg, FL 34748-5925 | 2009-01-23 |
| Find all providers in LEESBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.